‘Letting Go’ review: Ways to have a good death by Gail Bell
Reprinted from The Sydney Morning Herald 25 January 2018
Dr Charlie Corke is an Australian intensive-care specialist and a strong proponent of timely advanced-care planning. His book, Letting Go, walks the same terrain as Mannix but his map is the ICU of a busy hospital where decisions are made on the run, as it were, not in the relative quiet of a hospice setting. His patients arrive in ambulances, desperately ill, close to death, often unable to communicate their wishes, and reliant on a frantic relative's instructions.
In crisp, clear prose Corke confronts the reader with the scenario most of us in Western society are likely to face after a period of declining health and function: ambulance, hospital, unconsciousness, no plan in place, family disagreements about treatment, escalation of medical intervention, and finally, our last days spent "connected to machines, cared for by strangers, and separated from family".
"Medical terminology will dominate our last days and weeks," he writes.
While not denigrating his own profession, he takes a humanistic approach to its limits. The reader learns of the "covenantal ethic" whereby a surgeon promises to use his or her skills "to battle death on behalf of the patient. In return, the patient puts their trust in the surgeon and accepts whatever is required". The covenant can have unwanted outcomes, notably when a surgeon has not been given prior permission "to stop if things [go] badly".
Keeping in mind that "saving is what doctors do", Corke advocates forward planning well in advance of old age and infirmity, in writing, with the added backup of an appointed decision maker.
Making choices is hard. Corke suggests that "prior (well-considered) wishes should carry more weight than a later decision made in a crisis". And he covers all the bases, from religious to legal ramifications, to distorted portrayals of the success rates of CPR in TV and film, and emotive journalism around withdrawing life support.
The book ends with practical tips and accompanying case histories, tying up Corke's thesis with the kind of wise, informed advice we crave in the era of Dr Google, advice that may be more useful than we think in light of the recent Productivity Commission Report into palliative care in Australia. Seventy per cent of Australians wish to die at home, without pain and surrounded by family. The "without pain" part is the work of the severely underfunded palliative care sector. Fourteen per cent achieve that goal.
As a manual for how to avoid ending up in ICU, in what one of Corke's patients called "the bad bit at the end", Letting Go is a guide book for our age.
Dr Corke will be presenting the Occasional Lecture, ‘Letting Go, How to plan for a good death’ on June 8th at 1.30 pm at Lions Village Main Hall 12-16 Kooringa Place Torquay
Trivia afternoon to end term two -for when your brain doesn’t want to retire
Trivia is about discovering secrets that make the everyday world more real, surprising, and exciting. Knowing all the tiny, absurd details that create places, history, movies, and games makes all of those things more important and interesting.
What makes trivia so challenging (and fun) is that the questions can come from virtually any area of knowledge.
Trivia does help to engage the part of the brain that plays a major role in the processing of memories.
Thus, trivia helps to keep the mind sharp and engaged but knowing the answer does not necessarily mean that one is smarter than everyone else; it just means that you know the answer.
On June 26th from 1.00 to 4.00pm there will be a Trivia afternoon as a term break-up at the new Kurrambee Myaring Community Centre 12 Merrijig Drive Torquay with host Tim Robinson.
Make up your own team of 6 or come on your own or with a friend and join a team on the day. Bring your own nibbles and refreshments and test your knowledge of everything that does not matter.Enroll online from June 5th
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